학술논문
Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon.
Document Type
Academic Journal
Author
de Sousa DRT; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; de Oliveira Guerra JA; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Universidade do Estado do Amazonas, UEA, Manaus, Brazil.; Ortiz JV; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; do Nascimento Couceiro K; Universidade do Estado do Amazonas, UEA, Manaus, Brazil.; da Silva E Silva MRH; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Jorge Brandão AR; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Guevara E; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Arcanjo ARL; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil.; de Oliveira Júnior EF; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Smith-Doria S; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Mwangi VI; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Morais RF; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Silva GAV; Fundação Hospitalar de hematologia e Hemoterapia, HEMOAM, Manaus, Brazil.; Molina I; International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d-Hebron University Hospital, Barcelona, Spain.; Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC)| Institute of Health Carlos III, Madrid, Spain.; Silveira H; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.; Ferreira JMBB; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Universidade do Estado do Amazonas, UEA, Manaus, Brazil.; Guerra MDGVB; Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas/Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.; Universidade do Estado do Amazonas, UEA, Manaus, Brazil.
Source
Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 9610576 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-3156 (Electronic) Linking ISSN: 13602276 NLM ISO Abbreviation: Trop Med Int Health Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To describe clinical, epidemiological and management information on cases of acute Chagas disease (ACD) by oral transmission in the state of Amazonas in western Amazon.
Methods: Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included.
Results: There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas.
Conclusion: The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.
(© 2023 Belgian Society of Tropical Medicine and the Prince Leopold Institute of Tropical Medicine.)
Methods: Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included.
Results: There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas.
Conclusion: The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.
(© 2023 Belgian Society of Tropical Medicine and the Prince Leopold Institute of Tropical Medicine.)